Healthcare Management & Administration Blog

Resuscitation Best Practices for Staff with Arthritis or Carpal Tunnel Syndrome

March 20, 2018

Our customers recognize the value in training staff on the Voice-Assisted Manikins to ensure that standardized quality CPR is being learned. They often ask how their organization can assist staff with physical limitations or disabilities to be successful in the completion of BLS or ACLS Hands-On Sessions using Voice-Assisted Manikins (VAMs). TriHealth (Cincinnati, OH) has developed a very successful HeartCode BLS Program.

They have several staff with physical challenges that are required to maintain BLS certifications. Over the past few years they have worked to develop best practices to support staff to successfully complete Basic Life Support certification on the VAMs. Here are six of our most common resuscitation practice and certification tips for staff members who are challenged by arthritis in their hands or wrists, or are afflicted with carpal tunnel syndrome:

Take a washcloth and fold it 3-4 times. Once the employee verbalizes accurate hand placement, place the washcloth on the manikin chest with paper tape. Have the employee place the palm of his/her hand on the washcloth which does two things: (1) Cushions the surface of the chest, and (2) Elevates the angle of the wrist/hand. Employees state over and over again that this really helps them. Inform the employee that in a real situation, he/she could grab any similar item to place under the hand (corner of a towel, scrub jacket, draw sheet), and compressions are still effective.

If an employee wears a wrist brace or requires extra support, he/she may want to wear the brace while performing compressions. Employees think they have to remove the brace, but it is not necessary.

Adult Manikin - When clasping hands, do not intertwine fingers. Instead, place dominate hand on bottom and angle hand inward so it feels more natural. Take non-dominant hand and encircle thumb and index finger around dominate wrist. The palm of top hand should be centered over the back of bottom hand. The hands should cover the exact same space (looks like one hand with fingers extended over either top side… your hands should resemble wings).

Infant manikin - If fingers are too painful or weak to do compressions, the pad of the thumb is the same width of the pad of two fingers. Place the pad of thumb on sternum at nipple line and just below (same placement as two fingers). Extremely important to not put your fingers in a fist – fingers should be extended.

Infant manikin - You can take the second hand and hold the hand you are using to perform compressions. This way you have the strength of two hands, which will ease discomfort and increase strength promoting ability to perform adequate depth of compressions.

Ventilations - For both Adult and Infant, use the Bag-Valve-Mask (BVM) and hold the bag under the arm or at the hip and press against your body with your forearm to deliver air.